On Medication

Alongside psychotherapy, psychotropic medication (i.e. medication that works on mental health difficulties, hereafter referred to as simply ‘medication’) is the most common treatment for mental health difficulties. It is sometimes prescribed as a stand alone treatment and sometimes as an adjunct to psychotherapy. There is often confusion about who prescribes medication and who provides psychotherapy. To clarify, here are some of the most common mental health professions that provide psychotherapy:

  • Clinical Psychologist

  • Counseling Psychologist

  • Clinical Social Worker

  • Licensed Professional Counselor

  • Marital and Family Therapist

  • Psychiatrist

Here are the mental health professions that typically prescribe medication:

  • Psychiatrist

  • Psychiatric Nurse Practitioner

While not specialized as mental health professionals, medical doctors who are general practitioners and physician’s assistants will also sometimes prescribe medications. There are also a few states (Illinois, Louisiana, and New Mexico) where psychologists who have undergone additional training can prescribe medications.

A psychiatrist is a medical doctor specialized in the diagnosis and treatment of mental health issues. Some psychiatrists both prescribe medication and provide psychotherapy, while others choose to focus only on prescribing and managing medications. Outside of psychiatrists, none of the professionals in the list of psychotherapy providers can prescribe medication, and when they think that a patient may benefit from medication they will refer that patient to a professional such as a psychiatrist who can prescribe medication. Ultimately it will be that latter professional’s decision as to whether medication is an appropriate form of treatment, and to answer any questions a patient may have about medication (e.g. ‘how long and how frequently should I take it for?’, ‘what should I do if I decide I do not want to take it anymore?’, ‘what are the possible side effects?’).

Many emotional difficulties such as anxiety and depression often have a genetic component to them in the sense that certain people are born more predisposed than others to these conditions (Kendler, Gardner & Lichenstein, 2008). Medication can be an especially valuable form of treatment for people who do have these predispositions, as they may experience some emotional challenges even in the absence of clear environmental stressors or painful early experiences that are treated by behavioral and psychodynamic therapies.

For many patients, the combination of medication and psychotherapy ends up yielding the best results. It is not uncommon for patients to be in a high degree of distress when they first seek help, and for their symptoms to be causing significant impairment in their day-to-day functioning. Medication can often help alleviate their symptoms enough that they can continue to meet the demands of their daily lives, helping to keep them afloat while they engage in the longer-term work of psychotherapy that eventually helps them to resolve their underlying difficulties.

References

Kendler, K. S., Gardner, C. O., & Lichtenstein, P. (2008). A developmental twin study of symptoms of anxiety and depression: evidence for genetic innovation and attenuation. Psychological Medicine, 38(11), 1567-1575.